# Case Report: Heart Transplantation for Refractory Candida tropicalis Endocarditis: A Case Report and Literature Review

## TL;DR

Heart transplantation was used to successfully treat a severe and drug-resistant fungal heart infection.

## Contribution

This case report highlights heart transplantation as a potential last-resort treatment for refractory fungal endocarditis.

## Key findings

- Heart transplantation successfully treated refractory Candida tropicalis endocarditis.
- Only two cases of fungal endocarditis have been treated with heart transplantation in the literature.
- The patient remained infection-free for two and a half years post-transplantation.

## Abstract

Candida infective endocarditis presents therapeutic challenges with high mortality. A complex case of Candida prosthetic valve endocarditis refractory to standard antifungals (anidulafungin and fluconazole) and high-dose caspofungin was successfully treated with heart transplantation. The literature review revealed a few cases of bacterial endocarditis successfully treated with heart transplantation, but with only two transplanted cases of fungal endocarditis. This report explores heart transplantation as a last resort for managing refractory infective endocarditis. The patient is still alive and free of infection, two and a half years after transplantation.